Only a Third of U.S. Moms Who Plan to Breast-Feed Meet Goals

Formula-feeding at hospital is important barrier, study finds

MONDAY, June 4 (HealthDay News) -- Although most American women plan on breast-feeding their newborns, fewer than one-third of those who expected to exclusively breast-feed for three months or more met that goal, according to new research.

The biggest factor in whether or not a woman met her breast-feeding goal appeared to be whether a baby received supplemental feedings while in the hospital.

"We found that mothers able to exclusively breast-feed through their hospital stay were more able to meet their breast-feeding intentions," said the study's lead author, Cria Perrine, an epidemiologist in the division of nutrition, physical activity and obesity at the U.S. Centers for Disease Control and Prevention.

Results of the study were released online June 4 and are scheduled to be published in the July issue of Pediatrics.

The World Health Organization (WHO) and the American Academy of Pediatrics recommend that babies be breast-fed exclusively for the first six months of their lives. Previous research has found that only 35 percent of American infants are breast-fed exclusively for three months, and only 15 percent for the recommended six months, according to background information in the study.

In an attempt to increase the number of U.S. babies being breast-fed, UNICEF and WHO created a new program called the Baby-Friendly Hospital Initiative. The initiative identifies 10 steps hospitals can take to help encourage and support new mothers who are trying to breast-feed their newborns. Some of the steps include:

Let pregnant women know about the benefits of breast-feeding.

Help new mothers begin breast-feeding within an hour after the birth.

Teach mothers how to breast-feed and how to maintain their milk supply if they are separated from their babies.

Allow mothers and infants to stay together 24 hours a day (referred to as "rooming in").

Encourage breast-feeding on demand.

To see whether or not a mother's intention to breast-feed affected her success, and if Baby-Friendly hospital practices played a role in exclusive breast-feeding, the researchers reviewed data from the 2005 to 2007 Infant Feeding Practices Study II.

The investigators found 1,457 women who intended to breast-feed exclusively. From this group, more than 85 percent said they planned on breast-feeding exclusively for three months or more. Yet, only about 32 percent achieved this goal.

Women who were married, and women who had more than one child were more likely to achieve their breast-feeding goals. Women who smoked or were obese were less likely to achieve their breast-feeding goals. Women who intended to breast-feed exclusively for longer durations were also less likely to meet their goal, according to the study results.

Starting breast-feeding within an hour of birth, and not giving the baby supplemental feedings or a pacifier were associated with meeting breast-feeding goals. However, after the researchers adjusted the data to account for all of the hospital's practices, the only statistically significant factor that led to success was not giving babies supplemental feedings. Mothers of babies who weren't given extra feedings were 2.3 times more likely to achieve their breast-feeding intentions, reported the study authors.

"Breast-feeding needs to be established in the first few days, and if you don't get started then, you probably are not going to be able to stick with it. Our study shows that we're not supporting mothers as much as we need to," said Perrine, who added that each year, more and more hospitals are becoming Baby-Friendly Hospitals.

"This study is very consistent with everything else that's been said on breast-feeding, and the Baby-Friendly practices really make a dramatic difference in breast-feeding initiation and duration," said Dr. Ruby Roy, an assistant professor of pediatrics at LaRabida Children's Hospital in Chicago.

"Making what we think of as simple changes really can have a profound impact on what moms are able to do," she said. For example, not giving supplemental feeding is a "big deal," according to Roy. "The practice of supplemental feedings usually means that mom and baby are separated for long periods of time, and that's not good for breast-feeding. It means that someone might not be paying attention to when the baby wants to be fed, and by the time baby gets to mom, the baby is so hungry that he or she is wailing." And, starting a breast-feeding session with a baby who's ravenous and crying isn't the best situation for success.

Roy also said that many women don't ask questions if breast-feeding hurts. Instead, they may just stop. "Pain is not normal. It means something is wrong. Get help. And, expect that breast-feeding is going to take more time and energy than you expect," advised Roy.

Once breast-feeding has been established, Roy said that many mothers lose confidence in breast-feeding when their child is going through a growth spurt. They think they've lost their milk supply when, in fact, the baby has just drained the milk because he or she is feeding more to fuel growth.